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General NPI Number Information
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NPI Number | 1669492229
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Entity Type | Individual
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Provider Name | HOWARD ELIOT GILMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1172 E RIDGEWOOD AVE SUITE #7
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-3936
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Country | US
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Telephone | 201-612-6050
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Fax | 201-612-0422
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Provider Business Mailing Address
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Address Line | PO BOX 1227
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City | RIDGEWOOD
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State | NJ
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Zip | 07451-1227
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Country | US
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Telephone | 201-612-6050
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Fax | 201-612-0422
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA05094900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 138479
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License Number State | NY
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